| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PFS INSURANCE GROUP LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 13.48% |
| CENTERSTONE INSURANCE AND FINANCIAL Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $12K | $15K | 5.86% |
| PFS INSURANCE GROUP LLC Filed as: PFS INSURANCE GROPU LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $5K | $18K | 17.31% |
| V.W. ALLABASHI & ASSOCIATES, LLC | 6455 SOUTH YOSEMITE ST. STE 300 GREENWOOD VILLAGE, CO 80111 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $276 | — | $276 | 0.27% |
| PFS INSURANCE GROUP LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $391 | — | $391 | 4.51% |
| PFS INSURANCE GROUP LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $391 | — | $391 | 11.16% |
| KIMBER K. KORSGAARD4 | 1112 OAKRIDGE DR UNIT 104 FORT COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $250 | — | $250 | 12.49% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $240 | — | $240 | 11.99% |
| KIMBER K. KORSGAARD4 | 1112 OAKRIDGE DR FORT COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $169 | — | $169 | 14.38% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $136 | — | $136 | 11.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Non-monetary compensation; Other services; Participant communication; Claims processing; Direct payment from the plan; Contract Administrator; Float revenue; Named fiduciary Service code 12 | — | $29K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 120 | $268K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $104K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $104K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $104K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $104K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $104K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 120 | $256K |
| Other(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 102 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.